EHRs tied to better treatment of high-risk heart patients

Doctors' letters sent after employing electronic health records led to a higher prescription rate for cholesterol-lowering medication and lower long-term cholesterol levels for patients with high-risk cardiovascular disease, according to Northwestern University medical researchers.

"It is important to get high-priority preventive care messages to patients in a variety of ways," said Stephen Persell, M.D., assistant professor of general internal medicine and geriatrics at the Northwestern's Feinberg School of Medicine, and first author on the study report. "Sending a mailed message that depicts one's actual cardiovascular risk may lead some patients to action even though talking about treating cholesterol with their physician did not."

The Northwestern team believes automatic use of EHRs to identify candidates for risk-reducing interventions would result in better care delivered directly to patients. Nearly half (49%) of Americans have at least one of the three main risk factors for CVD — high blood pressure, high LDL cholesterol and smoking. However, standard risk assessment is not often performed in primary care, so physicians might not have accurate perceptions of their patients.

Test group members were twice as likely as the control group to receive a cholesterol prescription. After an 18-month follow-up, 22% had lowered cholesterol, compared to 16% of the control group.

"Many patients who had increased cardiovascular risk and got the risk message sent to them still did not get their cholesterol lowered,” Persell said, noting room for improvement. “Future studies can examine if repeated exposure to these messages leads to bigger changes over time.”